Part B Insider (Multispecialty) Coding Alert
Don't Be Too Forward, OIG Tells Carriers
The check may be in the mail - but you may never see it anyway. A mix-up with the address you have on file with your durable medical equipment regional carrier may mean that you never receive any more checks at all. A single returned check could lead to a moratorium on payments. If you change your address and don't notify your carrier, the Postal Service isn't allowed to notify the carrier for you, says the HHS Office of InspectorGeneral in a new report on the "Do Not Forward Initiative" (A-02-02-01023). Until you provide a valid address to the carrier, any claims received after one mailing bounces won't result in checks to the provider. Those claims will be "processed for adjudication only." Physicians and suppliers can update their addresses on file by using the 855B or 855S forms, for group providers and non-group providers respectively. The OIG says CMS has instructed carriers to void checks that come back in the mail and hold on to them for a year as "other liabilities." But due to weaknesses in the systems used by DMERCs and carriers, the Multiple Carrier System and the ViPS Medicare System, some returned items aren't being posted properly as expenses and liabilities. Instead they're being recorded as voided checks, warns the OIG in its report. That's leading the DMERC and carriers in Region II to misstate $4,845,530 in their financial reports, notes the OIG.
The DNF initiative has expanded as of last October, when the Centers for Medicare & Medicaid Services amended the Medicare Carriers Manual to say that hardcopy remittance notices also should bear the "Do Not Forward" stamp. Not only that, but carriers now won't pay physicians and suppliers by electronic funds transfer if they suspect the supplier's address may have changed, according to a recent carrier bulletin.
Part B Insider (Multispecialty) Coding Alert
- PHYSICIAN PAYMENTS:
'Vicious Cycle' Runs Over Physician Payments
Enjoy that 1.6 percent payment increase for 2003. It could be the last boost you [...] - HIPAA HELP:
Piggyback Privacy Rule To Make Security Compliance Load Bearable
There's good news and there's bad news about the HIPAA security rule. The bad news [...] - PHYSICIAN PAYMENTS:
Can Anything Save Physician Payments?
Now it's clearer than ever that physicians will suffer negative updates for the next few [...] - MEDICAL REVIEW:
Order Lab Tests And You May Hear From Carrier Reviewers
You now have only two weeks, instead of three, to respond to suspensions, offsets or [...] - MEDICARE REFORM:
Is The Bush Medicare Reform Plan DOA?
Nobody ever accused fee-for-service Medicare of being simple, but you might find yourself pining for [...] - CODING:
Don't Overbill For Stable Nursing Home Patients
When the doctor drops by the nursing home, it barely seems worthwhile to bill the [...] - CODING COMPLIANCE:
4 Tips For Painless Lesion Excision Coding
Lesions: All physicians have to deal with them in one capacity or another, and they [...] - EVALUATION & MANAGEMENT:
Outpatient Teaching Doctors Face Confusion
When the Centers for Medicare & Medicaid Services unveiled new documentation requirements for teaching physicians [...] - COMPLIANCE:
Don't Be Too Forward, OIG Tells Carriers
The check may be in the mail - but you may never see it anyway. [...] - STUDIES & SURVEYS:
Less Is More, Says MedPAC
Some regions of the country are spending 60 percent more per patient on health care [...] - PRESCRIPTION DRUGS:
Lincare Contamination Leads To Investigation
To err may be human, but to track errors is the Food and Drug Administration. [...] - DRUG PRICING:
CMS Seeks Alternative To Inherent Reasonableness For Drugs
The trouble with bluffs is they wear off eventually. The Centers for Medicare & Medicaid [...] - INDUSTRY NOTES:
Doctors Need To Ballast Hot-Air Cost Balloon
It's partly doctors' fault that medical costs are shooting up, says one influential doctor. Mahendr [...] - CODING:
Surgically Remove Surgery From Aftercare Claims
Rehab practices may have welcomed the 30 new ICD-9 codes for postsurgical conditions [...] - LEGISLATION:
Medicare Escapes Narrowly From Cuts
The Medicare program has made a narrow escape from huge budget cuts proposed by Republican [...] - BUNDLING:
Call Carriers To Avoid Bundling Shortfalls
If home medical equipment providers and Part B therapists furnish supplies or care to a [...] - PRACTICE EXPENSES:
Oncologists Hope To Avoid RVU Pie Fight
Can the Centers for Medicare & Medicaid Services fix reimbursement for cancer care without having [...] - LEGISLATION:
House Committee Aims To Insulate ALJs From CMS
The House Ways and Means Health Subcommittee March 20 passed Medicare regulatory and appeals reform [...]
